In October 1985, RAND began an evaluation of the effect prospective payment based on diagnosis-related group was having on the quality of care given to hospitalized Medicare patients. This Note documents the structured implicit review form used for the implicit measurement of quality of care for Medicare patients hospitalized with congestive heart failure, acute myocardial infarction, pneumonia, c......

This Note contains a quality review form and guidelines for its use, developed for and used in the RAND PRO Quality Review Validation Study. The form and guidelines were designed for structured implicit peer review of hospital records by physicians, to assess the quality of inpatient care for diverse medical and surgical conditions. The guidelines are designed to be used in a preliminary training ......

To measure the quality of medical care before and after implementation of the Prospective Payment System (PPS) by Medicare, the authors developed methods for both implicit and explicit review of the medical record. Explicit review relies upon measurement of the extent to which care accords with previously specified criteria; implicit review depends upon a practitioner's expert opinion to develop a......

In an effort to contain health care costs, Medicare initiated a prospective payment system based on diagnosis-related groups (DRGs) in 1983. In 1985, RAND began a study to determine the effect of DRG-based prospective payment on quality of care for hospitalized Medicare patients. Six diseases (congestive heart failure, acute myocardial infarction, hip fracture, pneumonia, cerebrovascular accident,......

In an effort to contain health care costs, Medicare initiated a prospective payment system based on diagnosis-related groups (DRGs) in 1983. In 1985, RAND began a study to determine the effect of DRG-based prospective payment on quality of care for hospitalized Medicare patients. Six diseases (congestive heart failure, acute myocardial infarction, hip fracture, pneumonia, cerebrovascular accident,......

In an effort to contain health care costs, Medicare initiated a prospective payment system based on diagnosis-related groups (DRGs) in 1983. In 1985, RAND began a study to determine the effect of DRG-based prospective payment on quality of care for hospitalized Medicare patients. Six diseases (congestive heart failure, acute myocardial infarction, hip fracture, pneumonia, cerebrovascular accident,......

Pneumocystis carinii pneumonia (PCP) is a form of pneumonia that is the most common serious infection in persons with AIDS and the most common cause of death. With early recognition and the timely use of antibiotics, however, PCP is treatable. Several studies have shown that treatment variations for PCP appear to be widespread, as in-hospital mortality rates ranging from 10 to 60 percent have been......

In an effort to contain health care costs, Medicare initiated a prospective payment system based on diagnosis-related groups (DRGs) in 1983. In 1985, RAND began a study to determine the effect of DRG-based prospective payment on quality of care for hospitalized Medicare patients. Six diseases (congestive heart failure, acute myocardial infarction, hip fracture, pneumonia, cerebrovascular accident,......

In an effort to contain health care costs, Medicare initiated a prospective payment system based on diagnosis-related groups (DRGs) in 1983. In 1985, RAND began a study to determine the effect of DRG-based prospective payment on quality of care for hospitalized Medicare patients. Six diseases (congestive heart failure, acute myocardial infarction, hip fracture, pneumonia, cerebrovascular accident,......

This report documents the medical record abstraction form and guidelines for appropriateness of hysterectomy used in the HMO Quality of Care Consortium study of this procedure. The abstraction form was designed to follow the format of a medical record so that abstraction would be both accurate and efficient. For each item or group of items, the section of the medical record that was to serve as th......